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Mitral/Tricuspid Valvular Disease

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Association of Effective Regurgitation Orifice Area to Left Ventricular End-Diastolic Volume Ratio With Transcatheter Mitral Valve Repair OutcomesA Secondary Analysis of the COAPT Trial Outcomes of TTVI in Patients With Pacemaker or Defibrillator Leads: Data From the TriValve Registry Functional Mitral Regurgitation Outcome and Grading in Heart Failure With Reduced Ejection Fraction Patient and Hospital Characteristics of Mitral Valve Surgery in the United States Regurgitant Volume/Left Ventricular End-Diastolic Volume Ratio: Prognostic Value in Patients With Secondary Mitral Regurgitation Attenuated Mitral Leaflet Enlargement Contributes to Functional Mitral Regurgitation After Myocardial Infarction Prevalence and clinical implications of valvular calcification on coronary computed tomography angiography A Score to Assess Mortality After Percutaneous Mitral Valve Repair Thrombotic Risk and Antithrombotic Strategies After Transcatheter Mitral Valve Replacement MITRA-FR vs. COAPT: Lessons from two trials with diametrically opposed results
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Original Research25 May 2021

JOURNAL：Eurointervention. Article Link

Incidence and Standardized Definitions of Mitral Valve Leaflet Adverse Events After Transcatheter Mitral Valve Repair: the EXPAND Study

FM Asch, SH Little, GB Mackensen et al. Keywords: mitral valve leaflet adverse events; LAE; definition; MitraClip;

ABSTRACT

BACKGROUND - An independent panel of experts reviewed all investigator-reported cases of mitral valve leaflet adverse events (LAE) after MitraClipTM NTR/XTR in the EXPAND Study.


AIMS - We aimed to report the findings of the expert panel and standardize definitions for LAE.


METHODS - Standard definitions for different types of LAE were formulated and events adjudicated after detailed review by the expert panel.


RESULTS - Enrolling centers reported LAE in 35 cases, 11 leaflet injuries (9 tear, 2 perforation) and 24 single leaflet device attachment (SLDA). The panel confirmed LAE in 20 cases (2.0% incidence), 18 patients had SLDA and 4 had leaflet injury (2 cases had both SLDA and injury). Leaflet injury occurred during device implant and resulted in surgical valve replacement or death. SLDA-alone events were identified during implant (n=2), pre-discharge (7) or at 30 days of follow-up (7) and were resolved (£ 2+ residual MR) with additional clips in 75% of cases.


CONCLUSIONS - Mitral valve repair with MitraClipTM NTR/XTR is safe. The rate of LAE is lower than previously reported using older generation devices. The proposed definitions and findings will help differentiate leaflet injury from inadequate leaflet insertion and SLDA, and provide guidance to consistently diagnose LAE post MitraClipTM.

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